Hormone Treatment and Asthma

Women in postmenopause who are thinking about hormone therapy (HT) have yet another factor to consider as they weigh the pros and cons. HT may raise their risk of developing asthma.

A report, based on data from the landmark Nurses Health Study, confirmed that HT is associated with an increased risk of asthma. Earlier findings suggested asthma risk in women decreases at the time of menopause and increases with the use of HT. Recent studies also have shown that HT, particularly estrogen, has both pro- and anti-inflammatory effects.

The study also examined whether HT increases the risk of chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. Researchers, however, concluded that it does not.

"The effect of HT appears to differ between asthma and COPD," says R. Graham Barr, M.D., of Massachusetts General Hospital and Harvard Medical School and one of the investigators in the study. "HT may worsen inflammation or bronchospasm leading to adult-onset asthma but does not appear to contribute to irreversible changes in lung function of COPD."

Menopause is when your menstruation stops and your ovaries stop making estrogen. The average age of reaching menopause is 51, but some women can reach it in their 30s and some in their 60s.

What is HT?

HT involves a daily dose of the hormone estrogen, either alone (known as estrogen therapy - ET) or in combination with a hormone called progestin. HT used to be a popular treatment for menopausal hot flashes, mood swings and vaginal/urinary tract symptoms.

Women in the Nurses Health Study who used estrogen alone had an increased risk of asthma compared with those who never used HT, after adjusting for age and smoking. The risks increase as dose and length of time increases. Women who used estrogen and progestin also had higher risks of asthma.

Talk to your doctor about HT

HT is still used to treat the symptoms of menopause. However, there are other risks along with asthma. The results of the Women's Health Initiative (WHI), a 15-year research program, showed that using HT for a long time increases the risk for cardiovascular disease, blood clots and breast cancer. The FDA only approves of hormone therapy for the relief of menopausal symptoms at the lowest effective dose for the shortest time.

Although the WHI studies showed some benefit in terms of having stronger bones and fewer fractures, HT is generally not considered a good choice for treating the brittle bone disease called osteoporosis. Talk with your health care provider to see if HT is right for you.

Related Articles Hormone Therapy, Estrogen Therapy and Menopause Menopause

External Sources Understanding Breast Cancer Treatment: A Guide for Patients, National Institutes of Health, National Cancer Institute. Understanding Breast Changes, National Institutes of Health, National Cancer Institute. A Woman's Guide to Breast Cancer Diagnosis and Treatment, California Department of Health Services. American Council on Science and Health

This article was reviewed and updated June 2007.

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